[Suprahyoid transpharyngeal approach to the median skull base in surgery of rhinoangiofibroma].

Ten young males with rhinopharyngeal angiofibroma (RAG) were studied. Except for one case of IIIb stage the others were all either I or IIIa. They all underwent surgery at the E.N.T. Clinic in Ferrara employing the transpharyngeal suprahyoid approach (TSA) originally described by Bocca. For the one case in the most advanced stage (IIIb), besides the TSA a paralateronasal approach and a complementary RT were also planned. In this series of cases, one recurrence due to a peritubaric residue was treated 8 months later through a transpalatal approach. The follow-up, with NED findings, varied from a maximum of 12 to minimum of 2 years (average 6.4 years), except for the last subject which underwent surgery in 1991. Three minor post-operative complications due to TSA were encountered, while 1 complication was attributed to the transpalatal approach used for the recurrence described. All cases healed completely. The data on the TSA from the international and national literature is reviewed underlining that the negative elements reported have, in the authors' opinion, been overcome by: perfecting the method for RAG exeresis and the method of the tracheotomy; making technological improvements: pre-operatory embolization, microsurgery applied to TSA in order to check any lateral branches and to the transnasal approach in order to check any residue in the choanal area.